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Agenda item

Fuel Poverty - Referrals to SHINE (Seasonal Health Intervention Network) - Presentation

Minutes:

Julie Billett, Director of Public Health gave a presentation on referrals to SHINE. In the presentation and discussion, the following points were made:

 

·         SHINE was a one stop shop established to tackle fuel poverty and reduce seasonal deaths and hospital admissions in Islington.

·         It worked in partnership across the borough to deliver a package of interventions designed to improve seasonal health and wellbeing.

·         The project had been running since the winter of 2010/11 and in that time had helped over 11,500 vulnerable residents across thousands of interventions.

·         Referral analysis showed that 47 NHS services and groups were identified as referring to SHINE. Each year there were a similar proportion of referrals from the NHS.

·         There were 49 GP referrals from 16 of the 34 Islington practices, mostly in 2014/15 and 2015/16.

·         There were 48 referrals from the dementia navigator service in 2014/15 and 2015/16. The dementia navigator service was a non-clinical service.

·         There were 39 referrals from health visitors who had contact with every family in the borough with a new child, 11 iCope (talking psychological therapy) referrals all in 2014/15 and 2015/16. There was a decline in referrals in 2014/15 and 2015/16 from most other services.

·         Non-NHS referrals came from services such as housing, caretakers, council staff and the voluntary and community sectors.

·         The low percentage of NHS referrals could be due to a council run service not being a classic place for health professionals to refer patients. The challenge was to get health professionals to think of SHINE as a place to refer people. Health professionals had pressure on their time and in short appointments were often unable to explore the wider influences and determinants around the health condition being presented.

·         Seven training sessions were held in March and April 2016 on health and housing for primary care practitioners. This was part of the Islington Community Education Provider Network (CEPN) working with the Recovery College. This was multi-disciplinary training aimed at breaking down barriers between disciplines.

·         Around 60 front line health practitioners, including GPs and health visitors were present over the sessions.

·         A training session had been delivered for over 15 Age UK locality navigators.

·         Two sessions had been delivered for Children’s Centres in September and this included health visitors. Approximately 30 people were present over the two sessions.

·         A quarterly SHINE newsletter was distributed to many NHS staff.

·         SHINE was included in Making Every Contact Count (MEDD) with 436 Islington staff completing online training and 150 Islington health and social care staff completing ½ day training to date.

·         Making Every Contact Count was launched in June 2016. It made use of conversations staff had with residents every day. It delivered additional support and advice where appropriate to help local people improve their wellbeing in relation to healthy living, money worries, debt and fuel poverty, unemployment and housing concerns. SHINE was an integral part of MECC.

·         Receptionists, nurses and the wider primary care workforce could all refer to SHINE.

·         Feedback on individuals’ progress to referrers was a positive reinforcing action which encouraged further referrals.

·         SHINE was embedded in the GP “Map of Medicine” which was a computerised pathway system used by medical professionals to refer people to the most appropriate place.

·         MECC (and hence SHINE) was being embedded in new NHS standard contracts and new staff would receive training.

·         SHINE participated in locality multi-disciplinary teams, although housing was often not raised as an issue by health services.

·         Islington Winter Warmth campaign consisted of SHINE (contacting known clients aged 70+, or had a child under 5 or had a disability), Help On Your Doorstep (identifying neighbourhoods of high deprivation and then knocking on every door in that neighbourhood), North London Cares (volunteers provide a mix of befriending, social activities and practical help to older residents), Housing (visit to tenants aged 75 and over), Age UK and Pensioners forum, CCG activities (e.g. flu campaign).

·         Gap analysis showed there had only been one referral from Community Pharmacists despite training. There were opportunities to encourage them to refer to SHINE.

·         There had been a slowing of referrals from health visitors. There was the potential to include this in all new birth visits or at the one year of 2 ½ year reviews.

·         Referrals from 16 out of 34 GP practices suggested scope for increases including referrals from practice nurses (9 to date) and health care assistants.

·         Two individual GPs had made seven referrals each so there was a potential for SHINE peer champions.

·         CCG Care navigators were not currently represented in referrals so there was the potential to provide training for them.

·         Referrals from teams across UCLH and some Whittington Hospital departments had slowed in recent years. Staff turnover created a training issue and busy departments did not always think about referring to services such as SHINE. There was the potential to raise awareness or provide training sessions.

·         In response to a question about whether sharing hospitals with other boroughs prevented hospitals from referring and whether there was a case for rolling out SHINE to other boroughs, Julie Billett advised that Camden had a similar service – Wish Plus. SHINE was a model that could, in theory, be rolled out elsewhere taking account of local circumstances and services available.

·         The chair suggested that the Health and Wellbeing Board should do more to promote SHINE. Julie Billett stated that the board operated at a strategic level and recognised the importance of health and housing. The Health and Wellbeing Strategy referred to SHINE as helping to address health and housing issues. The Health and Wellbeing Strategy was being revised and was currently being consulted on so the committee could contribute to the consultation.

·         In response to a query as to whether councillors could refer people to SHINE, members were advised that they could.

·         In response to a question from a member of the public about whether teachers and school staff were offered MECC training, Julie Billett said school nurses were offered the training.  She was not aware if other school staff were offered training but would take this suggestion away to look into.

 

RESOLVED:

1)    That the presentation be noted.

2)    That the committee respond to the consultation requesting that SHINE be included in the Health and Wellbeing Strategy as a priority and that the scrutiny report on Fuel Poverty be included for information.